[Factors associated to the coiling of umbilical cord: case-control study conducted in three hospitals in Yaoundé]. / Facteurs associés aux circulaires du cordon: étude cas-témoin dans trois hôpitaux de Yaoundé.

INTRODUCTION: The coiling of umbilical cord is the winding of the umbilical cord around a part of the fetal body once or several times. It is the most common abnormality of the cord, its prevalence varies according to the authors from 5.7% to 35.1%. In 2011, the rate of perinatal mortality due to the coiling of umbilical cord in Cameroun was 6.1%. However factors associated to it are little known in our context. Our purpose was to determine factors associated to the coiling of umbilical cord in three hospitals in Yaoundé. METHODS: We conducted an analytical case-control study in the Maternity Unit at the Central Hospital of Yaoundé, the University Teaching Hospital of Yaoundé and the Social and Health Nkoldongo Animation Center over a period of 4 months. The study-group composed of newborns with coiling of umbilical cord was compared with two control groups (newborns without coiling of umbilical cord). All the fetuses were cephalic at delivery (singleton pregnancies at term). Pre-established technical data sheets were filled with data collected and analyzed based on the Microsoft Excel 2017 and SPSS software Version 23. The parameters used for the analysis were the average age, standard deviation and frequency, the raw odds ratio (OR) and/or adjusted (aOR) with their 95% confidence interval. P was considered significant for any value less than 5. RESULTS: Out of a total of 3,300 deliveries, 500 newborns (15.15%) had coiling of umbilical cord. All the coils were around the neck. We retained and studied 136 newborns with coiling of umbilical cord (study group) vs 272 newborns without coiling of umbilical cord (control group). Factors independently associated with coiling were non editable: length of the cord = 70cm (ORa = 32 CI = 17.5-35 p = 0.02), male sex (ORa = 67.09 CI = 22.31 - 97.46 P = 0.001), APGAR score 5th minute <7 (ORa =76.98 CI = 2.19 - 27.05 P=0.017) and modifiable factors were gestational age = 42WA (ORa = 15.15 CI = 6.14-18.2 P = 0.001). CONCLUSION: The coiling of umbilical cord is a frequent cord abnormality. We suggest to the decision-makers to increase awareness among health workers and the population on the importance of ultrasound scan of the third trimester in order to detect coiling of umbilical cord and implement appropriate manage newborns. Clinicians should avoid as much as possible post-term pregnancy.

Dysménorrhée chez les élèves et étudiantes à Yaoundé : facteurs associés et aspects socioculturels

Introduction.: la dysménorrhée est une situation fréquente chez les femmes en âge de procréer. Elle affecte la qualité de vie des filles et est la principale cause d'absentéismes scolaires chez les adolescentes. Notre étude avait pour objectif d'analyser les facteurs associés à la dysménorrhée et les aspects psychosociaux de la dysménorrhée chez les élèves et étudiantes à Yaoundé. Méthodologie. L'étude était transversale analytique, réalisée dans 2 établissements secondaires et un établissement supérieur de la ville de Yaoundé, du 1er Décembre 2017 au 30 Juin 2018 soit une durée de 6 mois. Étaient incluses toutes les élèves et étudiantes âgées de 15 ans et plus, ayant leurs menstruations et au moins un niveau d'instruction de la classe de seconde. L'échantillonnage était stratifié en grappe de 2 niveaux dans l'un des établissements et consécutif dans un autre. Le rapport de côte a été utilisé pour rechercher les associations entre les variables et la valeur P ˂ 0,05 était considérée significative. Résultats. Parmi les 1059 participantes, 800 avaient des dysménorrhées soit une prévalence de 75,5%. La moyenne d'âge était de 18,88 ± 3,62 ans avec des extrêmes allant de 15 à 45 ans. Les facteurs de risque de la dysménorrhée étaient : indépendamment associés aux dysménorrhées étaient les antécédents familiaux de dysménorrhée [OR (IC à 95%) : 4,20(3,02-5,83)] et le stress [OR (IC à 95%) : 2,16(1,55-3,02] ; tandis que la durée des règles ≤ 3 jours [OR (IC 95%) : 0,31(0,12-0,82)] est un facteur protecteur. La dysménorrhée était considérée comme un sujet tabou par 23,6 % des participantes. Conclusion. Les antécédents familiaux de dysménorrhée et le stress sont des facteurs de risque de la dysménorrhée. Certaines personnes affectées préfèrent ne pas en parler. Nous recommandons de sensibiliser les femmes sur la dysménorrhée et les aider à lutter contre le stress

Seroprevalences and Correlates of Hepatitis B and C Among Cameroonian Pregnant Women.

BACKGROUND AND RATIONALE: Viral hepatitis B (VHB) and viral hepatitis C (VHC) are major public health issues in resource-poor countries where vertical transmission remains high. AIM: To assess prevalences and correlates of VHB and VHC among women attending antenatal clinic. METHODS: A cross-sectional study at the Yaounde Central Hospital from January 1 to June 30, 2016. We included 360 pregnant women who were screened for hepatitis B virus surface antigen (HbsAg) and VHCAb by rapid diagnostic test (DiaSpot Diagnostics, USA) followed by confirmation of positive results by a reference laboratory. Odds ratios (95% confidence interval [CI]) were used to measure associations between variables. Statistical significance was set for P-value <.05. RESULTS: Mean age was 27.9 ± 5.6 years. The prevalences of HbsAg and VHCAb were 9.4% (n = 34) and 1.7% (n = 6), respectively. Multiplicity of sex partners was significantly associated with HbsAg positivity (adjusted odds ratio [aOR]: 11.6; 95% CI: 5.1-26.7; P < .001) while none of the studied factors was associated with VHCAb. CONCLUSION: The high prevalence of hepatitis B among pregnant women supports systematic screening and free vaccination of pregnant women and women of childbearing age.

[Current status of schistosomiasis in Santchou health area, (Santchou Health District, Cameroon western region)]. / Situation actuelle de la schistosomiase dans l'aire de santé de Santchou, (District de santé de Santchou, Région de l'Ouest-Cameroun).

INTRODUCTION: Schistosomiasis, the second endemic parasitic infection in the world, is a parasitosis caused by trematodes from the genus Schistosoma. Our study aims to assess the prevalence of different species of schistosomes (Schistosoma mansoni, haematobium and intercalatum) among schoolchildren and to identify risk factors, clinical signs of schistosomiasis, and schistosomiasis intermediate host snails in stagnant water. METHODS: We conducted a cross sectional study over a three months period. The study consisted of sociodemographic and clinical data recording, collection of stool samples and urine, molluscan research and treatment of positive students for other helminths. Laboratory tests were performed at the Medical Research Institute and the study of Medicinal Plants in Yaounde where stool samples and urine were examined using KATO KATZ and centrifugation technique respectively, and shellfish species were determined by a malacologist. RESULTS: A total of 400 students aged between 8-16 years, 223 (55.7%) girls and 177 (44.3%) boys attending 4 elementary school were enrolled in the study. The social survey revealed that 154 students out of 400 (or 38.5%) were in contact with the river water at least once a week, 58% from around noon. All students had at least one symptom of schistosomiasis although nonspecific and dominated by abdominal pain in 72% of cases (n = 288 of 400). Biologically, no schistosomiasis eggs were detected. Cercaria releasing rate was negative in the 100 watery species found. CONCLUSION: The Santchou health area is not an active outbreak of schistosomiasis, but remains a risk area because of rice cultivation and stagnant water. The intensification of health education campaigns among the general population would delay the onset of this infection in the locality.

Associations of body mass index and gestational weight gain with term pregnancy outcomes in urban Cameroon: a retrospective cohort study in a tertiary hospital.

BACKGROUND: Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS: This was a retrospective cohort study at the Yaoundé Central Hospital. We included women with term singleton deliveries in the post-partum ward. The World Health Organisation classification of BMI and the United States Institute Of Medicine (IOM) categories of GWG were used to stratify participants. Poor maternal outcome was defined by the occurence of caesarean section, preeclampsia or obstetrical haemorrhage. Poor perinatal outcome was defined by the occurence of perinatal death, admission in intensive care unit, low birth weight, macrosomia or fifth minute Apgar score <7. Multiple logistic regressions were used to calculate unadjusted and adjusted Odds Ratios (uOR, aOR) for poor maternal outcome (PMO) and for poor perinatal outcome (PPO) in each category of BMI and GWG. Adjustment was done for age, scarred uterus, sickle cell disease, malaria, human immunodeficiency virus (HIV) infection, parity and smoking. RESULTS: Of the 462 participants, 17 (4 %) were underweight (BMI < 18.5), 228 (49 %) had normal pre-pregnancy BMI, 152 (33 %) were overweight (25 ≤ BMI < 30) and 65 (14 %) were obese (BMI ≥ 30). Following the IOM recommendations, GWG was normal for 186 (40 %) participants, less than recommended for 131 (28 %) and above the recommended norms for 145 (32 %). GWG above the IOM recommendation was significantly associated with PMO (aOR: 1.7, 95 % CI 1.1-2.8). GWG less than the IOM recommended values, overweight and obesity were not significantly associated with poor pregnancy outcomes. CONCLUSION: While waiting for local recommendations for GWG, the IOM recommendations can be used for Cameroonian women as far as maternal outcome is concerned. Unlike in studies in different ethnic and racial groups, abnormal BMI was not associated with poor pregnancy outcomes in our cohort of Cameroonian women.